{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T08:25:07Z","timestamp":1785659107562,"version":"3.56.0"},"reference-count":23,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009032","name":"Pfizer UK","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100009032","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,10,30]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Osteoarthritis (OA) affects 10% of adults in the UK. Despite over one-third of people with OA experiencing chronic pain, few studies have examined the population-level impact of chronic pain associated with OA. We compared resource-use and epidemiological outcomes in patients with mild, moderate and severe chronic OA-associated pain and matched controls without known OA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective, longitudinal, observational cohort study (July 2008 to June 2019).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Electronic records extracted from Clinical Practice Research Datalink GOLD primary care linked to Hospital Episode Statistics (HES).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Patients (cases; n=23\u2009016) aged \u226518 years with chronic OA-associated pain. Controls (n=23\u2009016) without OA or chronic pain matched on age, sex, comorbidity burden, general practitioner practice and available HES data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>None.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>Total healthcare resource use (HCRU), direct healthcare costs in 0\u201312, 12\u201324 and 24\u201336 months postindex. Secondary outcomes included incidence and prevalence of chronic OA-associated pain and pharmacological management.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>HCRU was consistently greater in cases versus controls for all resource categories during preindex and postindex periods. Across follow-up periods, resource use was greatest in patients with severe pain. In the first 12 months postindexing, mean total costs incurred by cases were four times higher versus matched controls (\u00a3256 vs \u00a362); costs were approximately twice as high in cases vs controls for months 12\u201324 (\u00a3166 vs \u00a386) and 24\u201336 (\u00a3150 vs \u00a381; all p&lt;0.0001). The incidence of new cases of chronic pain associated with OA was 2.64 per 1000 person-years; the prevalence was 1.4%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study highlights the real-world cost of chronic pain associated with OA in cases versus matched controls. We included patients with mild, moderate and severe pain associated with OA, and showed HCRU in discrete 1-year time frames. The true economic burden of pain associated with OA is likely to be considerably higher when indirect costs are considered.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-073096","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T12:56:32Z","timestamp":1701262592000},"page":"e073096","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Estimating the cost and epidemiology of mild to severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data"],"prefix":"10.1136","volume":"13","author":[{"given":"Christoph","family":"Lohan","sequence":"first","affiliation":[{"name":"Pfizer Australia Pty Ltd, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Coates","sequence":"additional","affiliation":[{"name":"Pfizer Ltd, Tadworth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Clewes","sequence":"additional","affiliation":[{"name":"Pfizer Ltd, Tadworth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Pfizer Ltd, Tadworth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6977-435X","authenticated-orcid":false,"given":"Robert","family":"Wood","sequence":"additional","affiliation":[{"name":"Adelphi Real World, Bollington, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Tritton","sequence":"additional","affiliation":[{"name":"Adelphi Real World, Bollington, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Massey","sequence":"additional","affiliation":[{"name":"Adelphi Real World, Bollington, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Knaggs","sequence":"additional","affiliation":[{"name":"Pain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre, School of Pharmacy, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair J","family":"Dickson","sequence":"additional","affiliation":[{"name":"Primary Care Rheumatology & Musculoskeletal Medicine Society, York, UK"},{"name":"The North of England Low Back Pain Pathway, NIHR Applied Research Collaboration (ARC) North East and North Cumbria, Saint Nicholas Hospital, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Walsh","sequence":"additional","affiliation":[{"name":"Pain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"2025101812490960000_13.11.e073096.1","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.joca.2020.03.004","article-title":"Trends in incidence and prevalence of osteoarthritis in the United kingdom: findings from the clinical practice research Datalink (CPRD)","volume":"28","author":"Swain","year":"2020","journal-title":"Osteoarthritis and Cartilage"},{"key":"2025101812490960000_13.11.e073096.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-021-04180-1","article-title":"The burden of chronic pain for patients with osteoarthritis in Germany: a retrospective cohort study of claims data","volume":"22","author":"Schild","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"2025101812490960000_13.11.e073096.3","unstructured":"NICE . 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